BORELLI CONSULTING: Tactical Equipment Reviews

Basic Immediate Action Medical Kit
Components for the Active Shooter Law Enforcement Responder
By Mike Marcon

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Preface

The Immediate Action Medical Kit, its basic components, uses and practical applications described in the following text are intended for the Active Shooter scenario where a hasty team comprised of one or more officers are responding to a threat.

Warning!This article’s purpose is to act as a primer regarding ONLY the important life-saving actions that would be taken under fire to preserve a responder’s life in the event of receiving a life threatening wound so that he or she or a partner may stay in or survive the fight. It is highly recommended that the reader have in-depth training and practice in the use of the IAMK components. The IAMK as described has only these uses:

1) To self aid the wounded officer, or a fellow responding officer under fire, and
2) To save a wounded victim’s life under fire.

The IAMK in this article should be vest or belt mounted and accessible by the non-firing or weak hand. The components described are to render only live saving measures before EMS care can access and safely treat a patient with more definitive care.

The use and contents of the IAMK is based on the following premise taken from Tactical Combat Casualty Care (TCCC) guidelines developed by Military Occupational Specialty training for the U.S. Army Combat Medic and is currently based on the principals of a Department of Transportation (DOT) Emergency Medical Technicians Basic course, and Basic and Advanced Trauma Life Support (ATLS). That premise is:

“90% of combat deaths occur on the battlefield before a casualty reaches a medical treatment facility.”

To the responding hasty team member(s) who may be wounded or who may encounter wounded innocents, the above phrase is important because those 90% of combat deaths are from hemorrhage. The same will be true in the active shooter situation.

Key point to remember in the use of an IAMK under fire:

Hemorrhage control is more important than breathing for the first 5 to 8 minutes after being wounded. Why? The average human can bleed out completely in less time than it takes for damage to result to the heart, brain and lungs from a lack of oxygen. Otherwise stated, blood is what carries oxygen to those vital organs. No blood, no oxygen. In the tactical scenario, it’s always control bleeding first, breathing second.

Key Points Under Fire:

1. Return fire as directed or required
2. The casualty(s) should also continue to return fire if able.
3. Keep yourself from getting shot
4. Keep the casualty from sustaining any additional wounds
5. Stop any life-threatening hemorrhage with a tourniquet
6. Defer airway management until under cover

Basic Components of the Immediate Action Medical Kit:

1) Tourniquet
2) Compression Bandage

While engaging the threat the responding officer receives a gunshot wound to an extremity. What is important? Answer: The type of bleeding involved.

The wounded officer must first ascertain the type of blood flow and color to determine the severity of the wound and subsequent threat to life:

First Type of Blood Flow: BRIGHT RED AND SPURTING - LIFE THREATENING!

This is an arterial bleed and blood loss will be rapid. Loss of consciousness and death is minutes away. The bleeding must be dealt with immediately, especially if the threat is still present and engaged. A tourniquet is called for and there is no time to worry about what damage to the extremity the tourniquet may cause in terms of cutting off blood flow and the subsequent tissue death to the lower aspects of the limb.

The whole point of using a tourniquet here is to keep blood flowing to the brain, heart and lungs.

This writer recommends the use of the SOF Tactical Tourniquet.

Although there many types of tourniquets available, this tourniquet is battlefield tested, affordable and easily applied one handed. An important point to remember here is that in the scenario, our responding officer is still engaged. He or she needs to continue to counter the threat as well as attempt to save their own life. The faster and more reliably the bleeding can be stopped the better. The SOF Tactical Tourniquet works.

This tourniquet is a simple nylon cinch strap type tourniquet with a lockable windlass that allows the user to quickly place the tourniquet at a site just above the wound, apply the needed amount of pressure to stop the bleeding and then to continue the fight without being concerned that the tourniquet will fail or loosen.

Second Type of Blood Flow: STEADY FLOW, DARK RED OR MAROON IN COLOR - USUALLY NOT IMMEDIATELY LIFE-THREATENING - BUT MUST BE CONTROLLED.

This is a venous bleed and the use of a compression bandage is recommended here. The goal here is apply pressure to the wound, slow the bleeding and, hopefully, the blood will clot and interrupt blood flow. Fortunately, for most healthy individuals, that will be the case.

The predominant compression bandages’ available today are designed to be self applied. Once applied, the bandage can be pulled to a degree of tightness that will cause the flow of the bleeding to slow or stop.

Another advantage of the compression bandage is that, applied properly, it will stop blood flow at the wound site but not to the rest of the extremity.

If the threat is still present, and this is the type of bleeding present, the goal is stay conscious and in the fight. Compression bandages can be applied using one hand, if necessary. This would the case if the wounded officer in this scenario was wounded on the upper or lower arm.

The compression bandages in use today have a mechanism that allows the user to place the bandage pad over the wound site, wrap the bandage tail across a tightening bar and apply moderate pressure. Once affixed, it will stay in place.

In conclusion, stop or control the bleeding with either a tourniquet or compression bandage and stay in the fight.

BE SAFE!!!

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Don't forget to check out our Recreational Equipment Review about multi-cam clothing for hunting nad the field.

This week's Training Article, a discussion about the difference between criticism and critique.

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